2018 Volume 27 Issue 4 Pages 277-280
Infected abdominal aortic aneurysm (IAAA) is a rare and life-threatening disease. An 86-year-old female was referred to our hospital because of fever, an abdominal pain, and a back pain. Biochemistry examinations showed a white blood cell count of 12300/mm3 and a C-reactive protein level of 16.5 mg/dL. Antibiotic therapy was administered. An immediate computed tomography angiogram (CTA) was performed, which showed a saccular shaped aneurysm and adjacent opacified extra-aortic space. The ruptured, infected and juxtarenal abdominal aortic aneurysm was diagnosed. Laparotomy was performed and the aorta was isolated and opened. A 4.0×2.0 cm defect of the intima, from which the aneurysm had arisen, was found in the posterior part of the abdominal aorta. The both renal arteries were cannulated and perfused with cold saline solution. Debridement of infected tissues and lavage of the aneurysmal sac were performed, thereafter, the defect was repaired by using bovine pericardial patch plasty. After reconstruction of the abdominal aorta, we performed omentopexy. Culture from abdominal aneurysmal tissue was negative. Antibiotic agents were administered for 4 weeks postoperatively until the patient demonstrated normal leukocyte and C-reactive protein levels. Thereafter, oral antibiotic treatment was continued for 11 months. No signs of recurrent infection and aneurysmal dilatation of the aorta were observed for 7 years after the procedure.
